A personal reflection on Medicaid at 50

By: Burton Edelstein

Medicaid will celebrate its 50th anniversary on July 30.

I entered college the year Medicaid was enacted. At that time I was unaware of its passage, how it would shape American healthcare, or what it would mean to me personally.

Over these 50 years, I first experienced Medicaid as a beneficiary when my wife faced acute healthcare needs beyond her employer coverage and my student coverage. I subsequently came to know Medicaid as an actively participating healthcare provider, an advocate for socially vulnerable children, a policy practitioner with the Children’s Dental Health Project (CDHP), a federal Commissioner on the Medicaid and CHIP Payment and Access Commission, and an analyst and investigator at Columbia University. I’ve lived the stigma of being refused care, the joys of providing care, and the rewarding engagements of working intensely to improve the program for those many people it serves. 

Every one of us is one major accident, disease, or disability away from the kinds of dependency that Medicaid honors.

I have come to understand Medicaid as the program that keeps poor and low income seniors from suffering, the disabled in the comprehensive care they need, and millions of children on the path to lifelong health. Medicaid is a program that is equal parts commercial-style insurance and safety net for those that commercial plans can’t afford to cover.

Despite all of its complexity and challenges, I celebrate Medicaid on its birthday. Every one of us is one major accident, disease, or disability away from the kinds of dependency that Medicaid honors. Its incredibly unique EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit for children is the only coverage, public or private, that is predicated on a holistic approach to supporting children’s health, growth, and development – including children’s needs for dental care. Medicaid is bigger than Medicare, broader than employer-sponsored insurance, and more flexible than any private plan.

As it heads into its sixth decade, Medicaid is demanding of itself to be more creative and dynamic in securing the triple aim of better care for individuals, better health for populations, and lower per capita healthcare costs. It is investing in innovation and sponsoring state-level redesigns. It is almost unique in prioritizing health as much as health care.

Despite dental expenditures for children being only a small fraction of its overall budget, Centers for Medicare & Medicaid Services has aggressively prioritized children’s oral health and dental care. We applaud its leadership and thank all who work to continue improving the program. I also applaud the day-in day-out work of CDHP staff who represent the best interests of children and their families as they work to make Medicaid and its sister program, The Children’s Health Insurance Program, the most effective program possible for children who need us most.




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Children with poor oral health were nearly 3x more likely to miss school due to dental pain.
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